Forum: Chemotherapy - Before, During, and After —

I've done several searches and have not found a T/FAC topic. I have 2 more Taxol treatments before I start FAC. Have any of you done T/FAC? I'd like to know what to expect from the FAC part. I've read about AC but wonder how adding fluorouracil to the mix might change the SEs.

I talked to my MO today and discussed SEs for FAC. She thinks that fatigue will be the worst SE and that will occur 4 to 7 days after treatment and will last 3-5 days (unless I have that backwards-hard to read my notes!). After that I will begin feeling better until after the next treatment.

She said also that since I have done well (!?!?) on Taxol she does not anticipate anything worse for me on FAC.

Tomorrow I start the first of 5 Neupogen shots, 480 mcg, one daily for 5 days.

Here are some photos from today's "experience"!

5-FU of FAC

A of FAC

The next one is also A of FAC, but please ignore how ugly I look in the photo. I'm a cancer patient! Plus my sister took the picture and then said "did I get all of your double chins?" I should have wrestled her into the chair and made her take the treatment!

The next one I couldn't resist taking. It's from MY point of view, and I love it! It is also the A of FAC.

Edited for - I messed up how to get the images to show here - I think it works now, but the sizes are goofy. I'll work on it.

I got my first neupogen injection today and it wasn't bad. I went to work for 4 hours this afternoon. I was tired when I got home and had to choose how to use my energy. Walk around the park for a while OR cook a healthy meal. The healthy meal won out. Tomorrow the walk!

I am taking the Claritin and Aleeve. My onc doesn't necessarily recommend it but one of her partners has in the past so she's okay with it. I told her I would rather try that than start out with hydrocodone that she recommended.

We didn't discuss the 'why' of the neupogen related to me, just the general need for it with this regimen. I know in the back of her mind was all the trouble I have had with the sinus infection from hell. I was expecting something like the first FAC, blood work the next week, then the decision on Neupogen. But she started right away. I'll have more blood work after these 5 shots.

I had the FAC on Wednesday, the neupogen on Thursday, had a very weird flushing on my face neck and hands last night. That looks better today. Today I'm a little wobbly feeling, but not nauseated or in pain. I think that's good, right!?

Its what dr alvarez calls my infected intermammary node on my official report. The petscan just said intermammary. I am glad u r doing good so far :-) lets hope it stays that way!!! im waiting on a call from dr alvarez to see how long exactly we should push back tomorrow. If my hubby packs like hell or we leave sun instead there is a chance we could still make it to mda on time. Can u tell i feel better :-)

I was planning on asking about the neupogen shot. My levels have stayed incredibly nirmal through all the taxol so I am hoping the can stay good throug fac.

I'm glad you're feeling better! and ready to get out of there. I hope your trip is uneventful and you still have some energy when you get there!

I've never had a petscan. Alvarez didn't order one. I'm hoping that's good! My white counts were good thru Taxol also. I probably should have questioned it more. I do know that she is going with the smaller doses of Neupogen instead of the bigger Neulasta. I does concern me that the stuff is made from e coli bacteria!

I'm stage 3 and under old guidlines stage 4 so they do the petscan to rule out potential progression. my onc in ky didnt think ins would pay for one.

dont worry about how they harvest the drugs. A lot of it is creepy and complicated. I did some if it in my undergrad. I have a fairly strong scientific background which is why i didnt like pam. She said theynwere the experts and i shouldnt question and just let them do their job. I told her if i didnt question i wouldnt have come to mda, my extra lymphs wouldnt have been caught and i would be at higher risk for progression.... :-)

Alrighty tighy, Yup I said it, or rahter the little lorazepram high I am on did. Haven't take this stuff normally refuse it but here at MDA they just do it. So I got IV Lorazepram, steroids and zofran first. A 30 min flush, the the FAC. Each was an infusion, no push and more flushing. It took about 3 hours with no pretesting.

I have to say I am feeling ok, and not looking forward to feeling like I got run over by a mac truck tomorrow. I had half a burger for dinner with the chemo and some fruit when I got home. So far all has stayed down. I will update as things go along also. The weird thing I found out is that the C (i think) can give you an elevated temp of up to 104 after the chemo for 4 hours that is anticipated and considered safe. Interesting huh. so far no fever, just hot flashes.

Also MDA does not do neulasta or neupogen shots unless there is some direct need for them. Thye don't do them preemtively because Jazzmun says there is no research that show it helps, so I am going to try to go it alone as long as I can. :)

Om lord. I dont feel bad except for the nausea. Zofran at 2 am and phennegran at 430 and my body is still nauseaus. I was kind of expecting it but i was hoping for the best :) not looking forward to the flight today.

My first two days after FAC were pretty normal and I was able to work. Saturday and Sunday I hurt. Nausea is hitting me also. I only took 2 Zofran during the whole 12 weeks of Taxol, but this is definitely NOT the same. Zofran am and pm and compazine mid-afternoon and bedtime. Oh and the constipation monster goes with those!

I was sick enough at the hospital on Sunday when I went for my shot that I had to call my sister to come drive me home. My blood pressure got very low and I had the shakes. Was retching into the little blue plastic bag, but happily my stomach must have been empty. I'm glad the worst was on a holiday weekend.

I went to work this morning at 10 am feeling shaky and sweaty. I made it to lunch time and hopefully I can finish out the afternoon. Tomorrow is a day off!

So i got fac mon. Mon night was ok. I woke up tues at 2 and took a zofran. It didnt help. I was able to take a phenegran and xanax later with the zofran and i was ok the rest of the day. Yesterday however... day 3 was not ok. Constant nausea no matter what i took. I had to pee like ever 10 min. Spent most of the day on the toilet with diahrea.... if i was sleeping it was fine. If not i was miserable. Today day 4 is not as bad. Zofran has been working. I actually ate some toast! Im still having toilet battles but i hope they will get better. Not looking forward to 3 more rounds of this.... but if the worst is only for a day or so it should be ok.

MMM, so sorry you felt so sick! My worst days were 3 and 4 but part of that was neupogen. For the next round I will try to stay away from the hydrocodone my onc gave for the neupogen pain. Looking back, that may have been the reason I got so sick on Sunday.

I didn't have the elevated temp that you mentioned earlier but on day 2 and 3 I looked like a beet-red Uncle Fester. The flushing started around my mouth and spread up to my hairline.

I also didn't have the diarrhea. The nurse said that the 5Fu can cause diarrhea and I almost cheered. Unfortunately not for me. But sorry it was you!

Yesterday I worked half a day and did well. Today I'll work for 6 or 7 hours. I am starting to feel pretty normal again. Just a bit sluggish. I may treat myself to a small road trip tomorrow, just to get out of the house, the office and dr offices. Those are the only places I've been since January.

OMG Phyllis my tastebuds are dead. Everything I love tastes nasty :( Brownies, cake, cottage cheese, even toast and crackers :( So far the only thing I can still taste is pizza. I even tried BBQ chips and I can't taste hardly any flavor. Sooo disapointing. I can still smell everything that smells good, but it just doesn't translate. I was anticipating htis, but not quite this fast. Do you have this problem yet?

So I think I figured out the diarrhea. Did you know you can be constipated (impacted and still have diarrhea that squeezes around it) I know nasty graphic, but apparently from the MDA paperwork I was reading over, it happens. Sometimes I just felt like I needed to blow out the toilet and couldn't go, but an hour later I would have small amounts of runniness. The MDA paperwork says definately to NOT take immodium in these instances. Its much better yesterday and today though. At leaste we have almost 2 more weeks before we have to subject ourselves to this again. After reading I am going to ask my home onc for Emend. Its supposed to be way better for the nausea. and see if that helps. BTW I was kind of excited for the diarrhea at first too... it meant I could eat bananas for the first time in months, but sadly I don't think that I was truely in that place.

I do have to say, when I asked Dr. Alvarez my questions this time he seemed a little cocky. Mostly just said I needed the "standard care". I am not and never have been a friend of being standardized. From my research BRCA really responds better to platinum chemos, but he doesn't want to talk about it and I was in the hospital too much the week before to "prepare" my mini research paper. Lemme know what you think at this visit. Pam was much calmer than before.

MMM, I'm sorry your tastebuds are dead!! Mine seem to be coming back. The first week after FAC mine were dead too. I had FAC on 2/15 and today is 2/25 and I can taste again. Well, not fully but SO much better. I hope yours will be back also!

As for the diarrhea/constipation problem. Oh for crying out loud! They invent chemo protocols but they can't fix this???? OH and while I'm on that soapbox, I'm having hot flashes again. They can make a pacemaker but not a new thermostat??!!

I looked up the standard anti-nausea protocol for AC and printed it for my first FAC appt. (Link at www.remm.nlm.gov/antiemetics.com) When I asked my onc what I would be having, it went by the list, so I was happy. The title of the page is Guidelines for Use of Antiemetics, 2006 Guidelines for Use of Antiemetics from Am Society of Clinical Oncology.

I had started reading about platinum chemos, but forgot to pursue it. However if those are for the BCRA positive patients, I don't qualify. Got my test results back and it was negative for the BCRA mutations 1 & 2.

I cancelled my March appt with Dr Alvarez because I'll be seeing Dr Bedrosian down there on 4/11. Jazzmun sent a message back asking if I wanted to schedule him on the same day I see her. I haven't answered yet. Last time I saw him (the Pam incident) he seemed just as you described. For cancer I suppose I prefer to be standardized and not need anything wild and crazier than standard treatment BUT, I sure don't like being talked to like I'm no longer an interesting case and he wants to hurry on to the next new patient. Having said all that, I'm still deciding if I want him to have another office visit fee from me. Particularly if he has nothing useful to add.

I had a beautiful day out on the road in the wilds of Nebraska with a stop for lunch at a Red Lobster (I could taste the seafood!) and a short shopping trip in Target. Then went to the Funk Waterfowl Production Area. Interesting place.....a bazillion ducks!

I hope your weekend is good and that you are growing new tastebuds right now!

Naw, platinum drugs aren't just for BRCA patients, infact the TCH they use for her 2+ the C is usually a carboplatin or cisplatin :) I have just read that BRCA can respond really well. Who is Dr Bedrosian? I don't really blame you for not seeing Dr. A. He kinda put me off this last time. I was concerned about over all prognosis, though I have never asked numbers and don't want to know and he was just very blasee (sp) about goign back to school if I want and living my life. Now Dr. Santiago (the radiologist who I ask for at every US) Her I LOVE! She is so enthusiatic and caring :)

Dr Bedrosian is my surgeon at MDA. Just want to let you know that this week I have felt the best since starting chemo. Definitely better than the weekly Taxol. I'm losing my poor toenails, though, from the Taxol. I hope you have a good weekend!

Tuesday's treatment time took forever! I was there from the blood work at 10:45 a.m. until 6 p.m. Wednesday I woke up queasy, shaky and with stomach cramps. I finally went to work about noon to give my co-worker a lunch break. Was able to stick it out until 4 p.m. for my neupogen shot. My blood pressure was low again so that may be why I felt so bad.

Woke up today with enough energy to put my computer back together! I don't go to work until 1 p.m. today so I can do a few things around the house.

Some friends came over last week and painted out my computer/guest/office room for me and everything is still stacked in my dining room. Maybe this weekend, I can get it all back together.

Is your next FAC on Monday? I hope it goes easier for you this time!

p.s. Amazing note: 2nd day after chemo and I could poop! hahaha. It take so little to make me happy these days! And most of my bloody boogers are gone!

yesterday was a long day also. There at 9 am for testing didnt leave til 2... oh well. It wnet fine and i lime my chemo nurses here. I felt a lil queasy yesterday but not terrible. They gave me iv emend.to help with day 3 nausea. I did ok after ther first one with no wbc boosters so i waved them this time. In factmy wbcs are at 7.2 and abs neutrophils are 4 +. My rbcs are dropping though. Slightly under normL. I hope they recover i dont really want a blood transfusion. I woke up feeling good andunched some crackers so i am hoping for an easy day today. As much as i hate both of.us.having to do this i do so love having a buddy! My legs did get a little.sore after standing for an hour and a half interview a pre school :) other than that all is well. At mda they hung 5fu and adriamyacin in a bag l. In lex they did both by push. They said you need nurse supervision with A because its a tissue necrotic if it leaks :( so far so good.with that. Just an interesting fact.

Hi ladies, glad to find you! I'm being treated at MD Anderson and will get Taxol weekly for 12 weeks and FAC every three weeks for 12 weeks. I start next Wednesday, March 28. Taxol followed by FAC must be a MDA regimen, since I'm not seeing much about it in these forums.

Kelly. Its definately mda standard. Taxol was a breeze i took l glutamine acetyl l carnitjne and a good multi vitamin. My labs hardly ever dropped and no neuropathy. The fac is much suckier but the emend has mad that even .more barable. We will stick with u through all of this!

Hi Kelly. MiniMacsMom is right that the FAC is suckier. Are you getting your chemo at MDA, or do you live elsewhere? Dr Alvarez is my oncologist at MDA but I get my chemo here in Nebraska.

Toward the end of Taxol I started experiencing neuropathy in my toes and fingertips. Also my toenails started turning purple. Once the neuropathy started I began taking L glutamine and acetyl L carnetine as well as gabapentin. The neuropathy is better and I hope it will eventually clear up. You might ask your oncologist if any of those medications are right for you.

There is information on these boards about icing fingernails and toenails to keep them from doing what mine are doing, I just didn't find it until very late in the Taxol treatment.

MMM - I talked with Erin in Dr Bedrosian's office and I may just cancel my April consultation appointment. With the FAC, I'm pretty sure that I won't feel like traveling plus I've just about decided to go ahead with a re-lumpectomy. The sentinel node biopsy will be done at the same time. We had already discussed that so the additional consultation won't really be necessary.

Erin estimated that surgery will be in mid-May since my last FAC is 4/17. I need to call her again to discuss the radiation part of treatment, though.

I have to say that it's a relief to know that I can wait until after FAC to travel. The first cycle was one bad week, one okay week and one great week. The second cycle was one bad week and two not-too-great weeks. Hopefully round 3 will be easier, but I suspect it may be cumulative.

I spent yesterday doing grocery shopping and and running a few errands. I even got in a walk in the evening. Today has been doing chores and stuff around the house. I needed to get all that done before Tuesday chemo and then the neupogen shots. I feel like I accomplished a lot!

Phyllis, Have you had your chemo nurses run 250 or 500 ml of saline after your chemo. I think that really helps. I usually pee grapefruit pink before I leave the infusion center. The nurses are really great, I just ask them to run it full out once the chemo is done. I truely think it helps. Also, the Emend was great. I didn't get them to run the saline in TX for week one and that was a much worse round. Also, we will be back in tx may 5/8-5/13 if you are there and want lunch. I meet with my surgeon on the 9th, and she will schedule my surgery at that point. They said its out patient so I won't have to stay for my re-excision on the armpit. I am sorry each treatment is getting harder. Have you tried going without the neulasta and getting a blood test to see how bad your WBC's tank before you get another. THat might help make you feel better. I was worried about you, its good to hear from you.